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General NPI Number Information
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NPI Number | 1043844624
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Entity Type | Organization
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Legal Business Name | FRONT RANGE TRANSITIONS COUNSELING & CONSULTATION
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Dates
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Enumeration Date | 02/23/2020
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Last Update Date | 02/23/2020
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Provider Practice Location Address
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Address Line | 645 GRANDVIEW MDWS DR
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City | LONGMONT
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State | CO
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Zip | 80503-9440
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Country | US
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Telephone | 847-800-8085
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Fax |
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Provider Business Mailing Address
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Address Line | 645 GRANDVIEW MDWS DR
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City | LONGMONT
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State | CO
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Zip | 80503-9440
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Country | US
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Telephone | 847-800-8085
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | KAREN JILL VAN ZUIDEN
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Credential |
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Telephone | 847-800-8085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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